Low cholesterol linked to worse survival in kidney cancer

People are often told to reduce their cholesterol to improve their heart health, but new research suggests that low cholesterol may increase kidney cancer patients’ risk of dying from their disease. The findings in this study, published in BJU International (2014; doi:10.1111/bju.12767), indicate that cholesterol testing may help doctors as they monitor and treat patients with kidney cancer.

Increasing evidence suggests that alterations in cholesterol and other lipids are associated with the development, progression, and prognosis of various cancers. To assess the situation as it relates to kidney cancer, Tobias Klatte, MD, of the Medical University of Vienna in Austria, and his colleagues analyzed total blood cholesterol levels in 867 patients with renal cell carcinoma before they underwent kidney surgery. The investigators then followed the patients for a median of 52 months.

Low blood cholesterol before treatment was associated with more advanced tumor stages and cancer spread during follow-up. Also, patients with high cholesterol had a 43% lower risk of dying from their cancer compared with patients with low cholesterol. Finally, including patients’ cholesterol levels with traditional risk factors increased the accuracy of prognoses.

It is unclear how cholesterol may affect the prognosis of a patient with kidney cancer. It may be that certain components of cholesterol impact the activity of cancer-related pathways to affect tumor growth and spread.

“As this was a hypothesis-generating study, our findings should be confirmed in independent datasets. If confirmed, patients with low cholesterol may be considered high-risk and may be treated or followed up more aggressively,” said Klatte.

The study concluded that, since cholesterol is a broadly available and routine marker, it may be useful in clinical practice. The authors stated that cholesterol increases the discrimination of established prognostic factors.